Managing a Medicare Advantage plan: What’s the recipe for success?

With this increase in the aging population comes an increase in health care needs, such as care coordination, addressing health-related social needs, helping individuals plan for long-term care, and aging safely in the home — not to mention the needs of overwhelmed family caregivers who need support in supporting their loved ones.

With Cleo being the only holistic family care platform that drives life-changing care to individuals, it’s a solid fit to support these needs. Cleo provides virtual coaching, concierge support, and navigation to resources and benefits so individuals and their caregivers can be happier and healthier.

We’re laser-focused on proactive family care, which allows us to identify risk factors related to physical and emotional wellbeing, social wellbeing, and health-related social factors early, in order to help prevent and decrease adverse events.

The best part of all of this is that we drive health outcomes and improve Star ratings. We’re a trusted partner in your member’s journey, creating a seamless holistic experience for themselves and their caregivers to help them thrive.

Cleo’s support for Medicare Advantage plans is unique in several ways. Here are four standout areas:

We coach to and through care as part of our care coordination.

A core component of Cleo’s model is coaching to and through care by systematically organizing a members’ healthcare services and benefits across different providers, ensuring seamless communication and continuity of care. Cleo coaches members “to” care such as getting the member and their loved ones connected to care, attending their appointments for prevention and management. Cleo also coaches members “through” care by empowering them, building their confidence to engage with the care and their providers, and integrating provider recommendations into their lives in the way that makes sense for them.

Cleo also integrates family caregivers into the care process, addressing logistical challenges (e.g., appointment scheduling, transportation, medication management), and facilitating access to supplemental benefits such as nutrition support or in-home assistance. Effective care coordination helps reduce hospital readmissions, improve health outcomes, and enhance the overall member experience by addressing gaps in care that complement the Medicare Advantage plan and its goals.

We act as an extension of care management.

This goes beyond traditional case management by providing additional layers of personalized support, particularly for caregivers and family members who play a critical role in a Medicare beneficiary’s well-being. This includes proactive engagement, ongoing education, and resources that empower caregivers to manage chronic conditions, navigate the healthcare system, and prevent avoidable health complications.

Cleo serves as an essential partner in ensuring that members receive not just clinical interventions but also the social, emotional, and logistical support needed to maintain their health at home. By extending care management in this way, Medicare Advantage plans can improve member satisfaction, enhance adherence to treatment plans, and ultimately lower costs through better preventative care.

We provide proactive, outcomes-based support.

Cleo proactively supports caregivers, recognizing that proactively protecting their well-being is integral to sustained positive outcomes, such as encouraging wellness visits, preventing emergency room visits, arranging mental health and cancer screening, and achieving other HEDIS measures.

We meet members where they’re at, and help build their confidence, anticipate needs, and provide evidence-based support that directly ties to the outcomes health plans care about. This forward-thinking strategy reflects Cleo’s commitment to long-term health improvements, reducing strain on the system, and ultimately leading to cost savings by preventing future health crises.

We focus on health-related social needs.

Social Determinants of Health (SDOH) refer to broad, systemic factors that shape an individual’s environment, such as socioeconomic status, institutional bias, and access to resources. These determinants are largely fixed and difficult to influence directly.

In contrast, Health-Related Social Needs (HRSN) are the immediate and tangible social and economic challenges that individuals face—such as access to nutritious food, transportation, or stable housing—that directly impact their ability to maintain health and well-being. While systemic issues like economic disparity are deeply entrenched and complex, Cleo recognizes that by providing targeted support to individuals and families, it can mitigate the downstream effects of these larger determinants.

Many organizations use SDOH as a buzzword, but Cleo takes a more actionable stance by honing in on HRSN — moving beyond theoretical discussions to practical, family-centered interventions. In doing so, Cleo not only enhances the quality of care for individual health plan members but also strengthens the broader support networks that contribute to long-term well-being.